Author: Futurity (National Geo)

Alcohol may improve an in-person party, but the same doesn’t hold true for Zoom happy hour, research suggests.

Results from a study published in Clinical Psychological Science suggest combining alcohol and virtual social interaction had negative effects compared to in-person gatherings.

In the study, participants video called either a friend or a stranger seated in a separate room. Researchers gave some participants alcoholic drinks and others nonalcoholic drinks.

As the call took place, researchers tracked participants’ eye movements, or “gaze behavior.”

The study showed that participants who consumed alcohol before conducting the video chat spent more time watching themselves during the conversation instead of their partners. They also felt more negative after the virtual exchange than the people who didn’t drink.

Additionally, the mood-enhancing properties of alcohol seen in in-person interactions weren’t seen in the virtual interactions, says coauthor Michael Sayette, a professor of psychology at the University of Pittsburgh.

“In a face-to-face conversation, we would expect alcohol to reduce your focus on yourself, which is one of the effects of alcohol that people seem to enjoy,” he says. “Yet in this online study, when your own face is staring back at you from the monitor, it seems that alcohol loses this effect. This may explain why some people don’t find alcohol to enhance socializing in a virtual format.”

Sayette also notes evidence that reducing one’s drinking or participating in Dry January or Sober October could provide longer-lasting health benefits.

“I would say that if you are not missing drinking, then there is no reason to return to it when February begins,” Sayette says. “It may turn out to improve your overall health, especially if you are a heavy drinker.”

Source: Donovan Harrell for University of Pittsburgh

A new study shows that levodopa, a drug that increases dopamine in the brain, has potential to reverse the effects of inflammation on brain reward circuitry, ultimately improving symptoms of depression.

Numerous labs across the world have shown that inflammation causes reduced motivation and anhedonia, a core symptom of depression, by affecting the brain’s reward pathways.

Past research from the department of psychiatry and behavioral sciences at Emory University School of Medicine has linked the effects of inflammation on the brain to decreased release of dopamine, a chemical neurotransmitter that regulates motivation and motor activity, in the ventral striatum.

In the study in the journal Molecular Psychiatry, researchers demonstrate that levodopa reversed the effects of inflammation on the brain’s functional connectivity in reward circuitry and anhedonia (inability to feel pleasure) in depressed individuals with higher C-reactive protein (CRP), a blood biomarker produced and released by the liver in response to inflammation.

Levels of inflammation can be easily measured by simple blood tests, like CRP, readily available in clinics and hospitals throughout the US.

The study included 40 depressed patients with a range of CRP levels from high to low who underwent functional brain scans on two visits after receiving in random order either placebo or levodopa, a drug often prescribed for disorders like Parkinson’s disease.

Levodopa improved functional connectivity in a classic ventral striatum to ventromedial prefrontal cortex reward circuit but only in patients with higher levels of CRP. This improvement in reward circuitry in depressed individuals with higher CRP also correlated with reduced symptoms of anhedonia after levodopa.

“This research demonstrates the translational potential for use of inflammation-related deficits in functional connectivity and could have important implications for the future investigations of precision therapies for psychiatric patients with high inflammation,” says principal investigator and senior author Jennifer C. Felger, associate professor of psychiatry and behavioral sciences at Emory School of Medicine.

Felger says the study findings are critical for two reasons. First, they suggest depressed patients with high inflammation may specifically respond to drugs that increase dopamine.

Second, Felger says these findings also provide additional evidence that functional connectivity in reward circuitry may serve as a reliable brain biomarker for the effects of inflammation on the brain.

“Moreover, as the effect of levodopa was specific to depressed patients with higher inflammation, this functional connectivity may be used to assess the responsiveness of the brain to novel treatments that might be targeted to this subtype of depressed patients in future studies and clinical trials,” says Felger.

Source: Emory University

When providers act to curtail water use because of a drought, water bills can rise for low-income families while dropping for high-income households, researchers report.

Access to safe, affordable water is a necessity for human health and well-being. But when droughts strike areas that are already water-stressed, water providers are forced to enact measures to curtail water usage or invest in supplies from more expensive sources, which can increase costs for consumers.

According to the new study, these measures can disproportionately affect water bills for low-income households, making water more costly for the most vulnerable people.

“A low-income household often has a different response to curtailment measures and surcharges because of how much water they used before the drought,” says Benjamin Rachunok, who conducted the work as a postdoctoral researcher at Stanford University and is now an assistant professor at North Carolina State University. “This can lead to different affordability outcomes for low- and high-income people, even if the same processes and policies are being applied to everyone.”

The researchers found that in some cases, low-income households end up seeing bills rise during droughts, while high-income households see their bills drop. The work illuminates the interconnected mechanisms that affect affordability and may be able to help water planners and policymakers better understand the potential impacts of long- and short-term drought responses.

Water bill affordability

Drawing on public data from the 2011 to 2017 drought in California, the researchers built a model to examine how different combinations of drought length and severity, various resilience strategies, and household behavior can affect the affordability of water.

“The standard way of thinking about the connection between water scarcity and affordability has been to look at the cost of supplying water and how that cost is passed on to users through rate design,” says Sarah Fletcher, an assistant professor of civil and environmental engineering in Stanford Engineering and the Stanford Doerr School of Sustainability and senior author of the paper in Nature Water.

“But in order to fully understand the impacts of drought on water affordability, we have to include people’s behavioral responses to how the drought is unfolding and the restrictions that are put in place.”

When there is a water shortage, providers often ask consumers to cut back on their water usage, while applying a drought surcharge to bills to make up for lost revenue. Fletcher and Rachunok found that high-income households can cut back significantly, lowering their average water bill even with the addition of a surcharge.

Lower-income households, however, tend to have less flexibility in their water usage. Even when they are able to curtail their water use, the drop does not make up for the additional cost of the surcharge.

Water utilities may also invest in infrastructure, such as desalination or water-recycling plants, to increase their water supply. The model showed that in all drought scenarios, these projects increase costs and reduce affordability for low-income households.

“Affordability is a key part of water access,” Fletcher says. “If we think about water security as including affordability for low-income populations, then some of the expensive technological measures that we often consider might actually harm water security by making water unaffordable for a larger number of people.”

Long-term water planning

Water is typically considered affordable when it does not exceed between 2% and 4% of a household’s income. While the cost of supplying water is the primary driver of water bills, even a small bill increase during droughts could make it difficult for some households to afford the water they need.

By providing insight into the mechanisms that affect affordability, Fletcher and Rachunok hope to help cities evaluate different approaches for long-term water supply planning. They are continuing to investigate how rate structures and other drought management techniques affect people’s behavior and are working to develop a generalized approach to help regulators make the best decisions for an uncertain future.

“We have a changing climate and changing water needs,” Fletcher says. “We have to develop approaches that allow us to adapt in robust ways so that we can still have water systems that are reliable, cost effective, and provide all the services that we need. And we should really be centering the needs of vulnerable communities as we do that adaptation.”

The Stanford Impact Labs and the UPS Endowment Fund at Stanford University funded the work.

Source: Laura Castañón for Stanford University

The unique genetics of Australian black swans leaves them vulnerable to viral illnesses such as avian flu, according to a new study.

The first-ever genome of the black swan reveals the species lacks some immune genes which help other wild waterfowl combat infectious diseases.

The geographic isolation of Australia’s black swans has meant limited exposure to pathogens commonly found in other parts of the world, leading to reduced immune diversity, says Kirsty Short, associate professor in the School of Chemistry and Molecular Biosciences at the University of Queensland.

“Unlike mallard ducks for example, black swans are extremely sensitive to highly pathogenic avian influenza—HPAI which is often referred to as bird flu—and can die from it within three days,” Short says.

“Our data suggests that the immune system of the black swan is such that, should any avian viral infection become established in its native habitat, their survival would be in peril.

“We currently don’t have HPAI in Australia, but it has spread from Asia to North America, Europe, North Africa, and South America. “When it was introduced to new locations, such as Chile and Peru, thousands of wild seabirds perished.

“The risk to one of Australia’s most unique and beautiful birds is very real, and we need to be prepared if we hope to protect it.”

With the knowledge from the new study, Short says researchers and conservationists hope to be able to better protect not only the black swan, but also other susceptible species across the globe.

“We want to increase awareness about how vulnerable Australia’s bird species are to avian influenza and the highly precarious situation they are in,” Short says.

The study appears in Genome Biology. Coauthors are from the Vertebrate Genomes Project (VGP).

The Australian Department of Agriculture and Water Resources and an Australian Research Council Discovery Early Career Researcher Award funded the work.

Source: University of Queensland

Current medical standards for accessing stroke risk perform worse for Black Americans than for white Americans, research finds.

The study, published in the Journal of the American Medical Association, evaluated various existing algorithms and two methods of artificial intelligence assessment that are aimed at predicting a person’s risk of stroke within the next 10 years.

The study found that all algorithms were worse at stratifying the risk for Black people than white people, regardless of the person’s gender. The implications are at the individual and population levels: people at high risk of stroke might not receive treatment, and those at low or no risk are unnecessarily treated.

“We need to improve data collection procedures and expand the pool of risk factors for stroke to close the performance gap of algorithms between Black and white adults,” says Michael Pencina, corresponding author of the study, professor in the department of biostatistics and bioinformatics at Duke Health and director of AI Health at Duke University School of Medicine.

“For example, the algorithms tested here mostly do not account for social determinants of health and some other factors suggested by the Stroke Prevention Guideline,” Pencina says. “Data collection needs to be closer to the patient and the community.”

“Disparities can potentially become propagated by these algorithms, and things could get worse for some people, which may lead to inequity in treatment decisions for Black versus white adults,” he adds.

The study specifically looks at something called risk ordering, which provides perspective on how likely someone is to experience stroke compared to others—an important concept used to allocate limited medical resources.

The study also finds that a simple method using answers to patient questions was the most accurate on a population level and that sophisticated machine learning methodologies failed to improve performance.

“While advanced AI techniques have been touted as the most promising path for better algorithms, our results indicate that for simpler types of data like the ones used in our study, complex math does not help,” Pencina says.

“The better accuracy of simpler algorithms, based on self-reported risk factors, suggest a promising and potentially cost-effective avenue for preventative efforts,” he says.

The study had funding from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health and from a cooperative agreement co-funded by the National Institute of Neurological Disorders and Stroke and National Institute of Aging.

Source: Duke University

A new blood test that can identify progression of osteoarthritis in the knee is more accurate than current methods, researchers report.

It could provide an important tool to advance research and speed discovery of new therapies.

The test relies on a biomarker and fills an important void in medical research for a common disease that currently lacks effective treatments. Without a good way to identify and accurately predict the risk of osteoarthritis progression, researchers have been largely unable to include the right patients into clinical trials to test whether a therapy is beneficial.

“Therapies are lacking, but it’s difficult to develop and test new therapies because we don’t have a good way to determine the right patients for the therapy,” says Virginia Byers Kraus, a professor in the medicine, pathology, and orthopedic surgery departments at Duke University School of Medicine and senior author of the study in the journal Science Advances.

“It’s a chicken-and-the-egg predicament,” Kraus says. “In the immediate future, this new test will help identify people with high risk of progressive disease—those likely to have both pain and worsening damage identified on X-rays—who should be enrolled in clinical trials. Then we can learn if a therapy is beneficial.”

Kraus and colleagues isolated more than a dozen molecules in blood associated with progression of osteoarthritis, which is the most common joint disorder in the United States. It afflicts 10% of men and 13% of women over the age of 60 and is a major cause of disability.

With further honing, the researchers narrowed the blood test to a set of 15 markers that correspond to 13 total proteins. These markers accurately predicted 73% of progressors from non-progressors among 596 people with knee osteoarthritis.

That prediction rate for the new blood biomarker was far better than current approaches. Assessing baseline structural osteoarthritis and pain severity is 59% accurate, while the current biomarker testing molecules from urine is 58% accurate.

The new, blood-based marker set also successfully identified the group of patients whose joints show progression in X-ray scans, regardless of pain symptoms.

“In addition to being more accurate, this new biomarker has an additional advantage of being a blood-based test,” Kraus says. “Blood is a readily accessible biospecimen, making it an important way to identify people for clinical trial enrollment and those most in need of treatment.”

The National Institutes of Health funded the work.

Source: Duke University

There were fewer cases of multi-system inflammatory syndrome in children during the Omicron wave of the pandemic than the Delta wave, according to a new study.

Multi-system inflammatory syndrome in children (MIS-C) is a rare but severe complication that occurs in children who’ve previously had COVID-19, and has near 1% mortality. Published in the journal Viruses, the findings show that those cases that did occur during Omicron were also milder than during Delta.

As shown in numerous other studies, during both waves, Black children were disproportionately affected by MIS-C, and were more likely to be admitted to the hospital with COVID-19. The authors attribute this to systemic and structural racial health inequities and note that limited analysis beyond this observation was possible as the study was not directed at contributions to racial health disparities.

“…during the change to Omicron, MIS-C has become milder and increasingly rare.”

The study demonstrates how the landscape of MIS-C keeps changing as new COVID-19 variants evolve. At the same time, the authors note that it is difficult to say what it means for the future.

“That’s the hard question,” says senior author Mark D. Hicar, associate professor in the pediatrics department in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo and a pediatrics infectious disease specialist. “Since we don’t know why the early strains of the virus caused more MIS-C and why Omicron causes less, it is hard to say if future strains will be worse or better.”

Likewise, he says, it is difficult to predict what the current strain XBB.1.5 will do, as this variant is beginning to flourish in the national data and it takes weeks before MIS-C cases emerge.

“Some recently published studies have suggested that MIS-C cases are becoming more severe, but those were based on 2021 data, before the Omicron wave really took off,” Hicar notes.

“Our study is one of the first to show that during the change to Omicron, MIS-C has become milder and increasingly rare,” he says. “This trend has continued and MIS-C is currently quite rare per anecdotal reports from colleagues across the country.”

He adds, however, that it is important to remain vigilant, as new strains of the SARS-CoV2 virus could cause an increase in incidence or severity of MIS-C.

MIS-C is changing over time

The retrospective study included 271 patients admitted to Oishei Children’s Hospital in Buffalo from August 2021 to February 2022, which included the majority of the Delta wave and when the Omicron wave (BA.1) was strongest.

A key strength of the study is that a panel of three infectious disease specialists made determinations on each case as to whether a child was admitted to the hospital due to COVID-19 or due to some other reason and then happened to test positive for the virus. To avoid potential false positives, the study relied only on cases proven to be positive through PCR testing.

The panel was established after first author Patrick O. Kenney, a medical fellow in infectious diseases, found that a number of children who were reported to be admitted to the hospital with only an incidental diagnosis of SARS-CoV2 on PCR actually were experiencing symptoms that were not as common during previous waves.

These included croup, which was first described by other groups, but also increased rates of seizures, bleeding events, and intra-abdominal inflammation including pancreatitis and hepatitis.

“Reports at the time supported that there was an increase in pediatric Omicron hospitalizations, but those reports focused on global admission data,” explains Hicar. “We wanted to take a deep dive and have thorough clinical chart review by three infectious disease physicians to decide if a case was admitted due to COVID-19 or for some other reason and happened to have COVID-19.”

“Even during major changes in the virus, from the Delta to Omicron variants, vaccines can be highly protective in preventing hospitalizations among children.”

This detailed approach helps to clarify how MIS-C is changing over time, especially in light of the decrease in severe cases during Omicron, Hicar explains. The study found that during Delta, MIS-C comprised up to 12% of hospital admissions at Oishei while during Omicron it comprised just 6% of hospital admissions. Based on their data, the researchers estimate the risk of MIS-C from Omicron in Western New York is 32% lower than it was during Delta.

The study notes that while there was an increase in pediatric hospitalizations in Buffalo during the Omicron wave, which was also the case nationwide, cases of both COVID-19 and MIS-C were generally less severe than they had been during previous waves of the pandemic. In addition, the length of hospital stays at Oishei Children’s Hospital as a result of either MIS-C or COVID-19 was relatively short during this period.

The researchers report that children testing positive for COVID-19 who didn’t have MIS-C during the Omicron wave exhibited a broad range of symptoms, especially among younger children, including seizures due to high fevers, as well as croup and related conditions.

By contrast, children who had MIS-C during Omicron exhibited a narrower spectrum of symptoms: they always had fever along with abdominal or upper respiratory symptoms. The authors note that none of the patients in the study met even incomplete criteria for Kawasaki disease; early in the pandemic, MIS-C was believed to be similar to Kawasaki disease.

Unvaccinated kids

The authors point out that the majority of children admitted to Oishei Children’s Hospital during Omicron with either COVID-19 or MIS-C had not been vaccinated.

Vaccines for children 12 and older became available before the study began and were available for ages 5-11 during the study. Among the 107 children admitted with acute COVID-19 during Omicron, vaccine status was recorded for 88 of them; of these, five were fully vaccinated and one had received a single dose. The others were unvaccinated.

Based on local county data that showed that 33% of children under 18 had been vaccinated as the Omicron wave began, rising to 42.1% by the end of the study period, the researchers calculated that the vaccines were between 87.8-91.7% effective in preventing hospitalizations for either COVID-19 or MIS-C among children.

“Our data show that even during major changes in the virus, from the Delta to Omicron variants, vaccines can be highly protective in preventing hospitalizations among children,” says Hicar.

Lorna Krabill, a fourth-year medical student in the Jacobs School, and Arthur J. Chang of Children’s Hospital and Medical Center in Omaha are coauthors of the study.

Source: University at Buffalo